FY2020 10/16/2019 P�,,.S cou 4F..o Rrdc
s°°°„ 1, Kevin Madok, CPA
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Clerk of/the Circuit Court&Comptroller— Monroe County, Florida
NROec°°
DATE: November 6, 2019
TO: Ammie Machan, Administrative Assistant
Tourist Development Council
FROM: Pamela G. Hanc•tip.C.
SUBJECT: October 16th BOCC Meeting
Attached are electronic copies of the following items for your handling:
F19 District I Destination Event Funding Agreements, as follows: Conch Republic
Independence Celebration, LLC, Conch Republic Independence Celebration 2020, in the amount
of$35,000.00; Florida Keys Community College and the letters "FKCC", FKCC Swim Around
Key West, Open Water Swims, Swim Meets, in the amount of$10,000.00; Monroe County
Commercial Fisherman, Inc., 15th Annual Florida Keys Seafood Festival, in the amount of
$17,000.00; Hemingway Sunset Run&Paddleboard Race, LLC, Hemingway Sunset 5k and
Paddleboard Race, in the amount of$17,000.00; International Women's Flag Football
Association, Inc., Kelly McGillis Classic, in the amount of$17,000.00; Key Lime Kings, Inc., Key
Lime Festival, in the amount of$17,000.00; Sunrise Rotary Foundation of Key West, Inc., Key
West Brewfest, in the amount of$25,000.00; Key West Film Festival Corporation, Key West Film
Festival, in the amount of$25,000.00; Dolce Events, LLC, Key West Food and Wine Festival, in
the amount of$35,000.00;The Lodging Association of the Florida Keys&Key West, Inc., Key
West Holiday Fest, in the amount of$50,000.00; Mote Marine Laboratory, Inc., 10th Annual Key
West Ocean Fest, in the amount of$10,000.00; Key West Business Guild, Inc., Key West Pride
2020, in the amount of$50,000.00; MultiRace LLC, Key West Triathlon (TRIKW), in the
amount of$25,000.00; Key West Police Athletic League, Inc., Mango Fest of Key West, in the
amount of$10,000.00; MZF Mile Zero Fights, L.L.C., Mile Zero Fights, in the amount of
$10,000.00; Bourbon Street Pub, Inc., New Year's Eve Shoe Drop, in the amount of$25,000.00;
Key West Track&Field Club, Inc., Pole Vault in Paradise, in the amount of$10,000.00; Key
West Business Guild, Inc.,Tropical Heat 2020, in the amount of$25,000.00; and Key West
Business Guild, Inc.,Womenfest 2020, in the amount of$35,000.00.
F20 District I Turnkey Events, as follows: Key West Tourist Development Association,
Inc., Fantasy Fest, in the amount of$150,000.00; Bauer Restaurant, Inc., Key West Songwriters
Festival, in the amount of$150,000.00; and Race World Offshore, LLC, RWO Offshore World
Championships, in the amount of$150,000.00.
F21 District II Destination Events, as follows: Lower Keys Chamber of Commerce, Inc.,
16th Annual Lower Keys Chamber of Commerce Nautical Expo, in the amount of$7,500.00; Phil
Peterson Charities, Inc., 47th Annual Phil Peterson's Florida Keys Poker Run, in the amount of
$10,000.00; I Love Stock Island Inc., Stock Island Seafood Celebration, in the amount of
$15,000.00; and Lower Keys Chamber of Commerce, Inc., 36th Annual Underwater Music
Festival, in the amount of$10,000.00.
KEY WEST MARATHON PLANTATION KEY PK/ROTH BUILDING
500 Whitehead Street 3117 Overseas Highway 88820 Overseas Highway 50 High Point Road
Key West,Florida 33040 Marathon,Florida 33050 Plantation Key,Florida 33070 Plantation Key,Florida 33070
305-294-4641 305-289-6027 305-852-7145 305-852-7145
F22 District IV Destination Events, as follows: Reef Environmental Education Foundation
Incorporated, 2020 Upper Keys Lionfish Derby and Festival, in the amount of$10,000.00; and
Islamorada Chamber of Commerce, Inc., 29th Annual Florida Keys Island Fest, in the amount of
$15,000.00.
F23 District III Destination Events, as follows: Marathon Post No. 154, Inc., Coral Head
Blues, in the amount of$20,000.00; Marathon Post No. 154, Inc., Coral Head MusicFest, in the
amount of$10,000.00; Hawk's Cay Resort Sales LLC, Heroes Salute Weekend, in the amount of
$30,000.00; Keys Area Interdenominational Resources, Inc., Sombrero Beach Run, in the amount
of$20,000.00; Marathon BPW Foundation, Inc.,Taste of the Islands, in the amount of
$20,000.00; and Greater Marathon Chamber of Commerce, Inc.,The Original Marathon Seafood
Festival, in the amount of$40,000.00.
F24 District IV Turnkey Events, as follows: Islamorada Running Company LLC,
Islamorada Half Marathon 10K&Beach N Beer Mile, in the amount of$20,000.00; and Friends
of the Pool, Inc., Swim for Alligator Lighthouse, in the amount of$30,000.00.
F25 District V Destination Events, as follows: CI Management Group Inc.,Jimmy
Johnson's "Quest for the Ring' Championship Fishing Week, in the amount of$20,000.00; HNO
Productions, Inc., Key Largo Bridge Run, in the amount of$10,000.00; and Reef Environmental
Education Foundation Incorporated, REEF Fest 2020, in the amount of$15,000.00.
F26 District V Turnkey Events, as follows: Key Largo Merchants Association, Inc., Key
Largo's Original Music Festival, in the amount of$30,000.00; Upper Keys Community Pool, Inc.,
Orange Bowl Swim Classic and Winter Training, in the amount of$40,000.00; and Phil Peterson
Charities, Inc., 47th Annual Phil Peterson's Florida Keys Poker Run, in the amount of$10,000.00.
F27 Multi District Destination Events, as follows: Key West Half Marathon LLC, 22nd
Annual Key West Half Marathon&5K, in the amount of$57,500.00; and Key West Tourist
Development Association, Inc., Fantasy Fest, in the amount of$40,000.00.
F28 Multi District Turnkey Event, as follows: Key Largo Merchants Association, Inc.,
Uncorked - Key Largo &Islamorada Food&Wine Festival, in the amount of$40,000.00.
Should you have any questions, please feel free to contact me at (305) 292-3550.
cc: County Attorney
Finance
File
Turnkey Event Agreement
THIS Agreement is made and entered into by and between Monroe County, Florida, a
political subdivision of the State of Florida (Co nty), and Key West Tourist Development
Association, Inc. (Event Contractor) on this Ile" day of 0C4bbert , 2019.
WITNESSETH:
In consideration of the mutual covenants contained herein the parties agree as follows:
1. Payment: A Turnkey event shall be considered an all-inclusive event where the
Event Contractor has financial responsibility for every facet of the production, promotion and
management of the event. Payment under an agreement for a Turnkey event will be made
only after completion of the event and proof that the scope of services as described below in
paragraph 2 has been completed. If a Turnkey event is delayed or canceled for any reason,
no payment shall be forthcoming, even if the Event Contractor has out-of-pocket expenses
leading up to the actual event. The Monroe County Tourist Development Council (TDC),
therefore, strongly recommends that the Event Contractor purchase insurance that covers the
cancellation or delay of an event due to "force majeure" or unforeseen circumstances (see
paragraph 9).
The County agrees to pay $150,000 (One Hundred and Fifty Thousand Dollars — TDC
District I Funding Allocation) for: Fantasy Fest in October 2020, from tourist development tax
funds upon receipt of documentation from Event Contractor, on or before the expiration date of
agreement in paragraph 3, that they have met its obligations under this agreement. Said
documentation shall also include samples of the Event Contractor's marketing program as
outlined in their application. Documentation submitted by Event Contractor will be reviewed
and verified by the Tourist Development Council (TDC) Administrative Office, at which time,
County shall pay the sum noted above.
Monroe County's performance and obligation to pay under this contract is contingent
upon an annual appropriation by the Board of County Commissioners.
2. Scope of Services: The Event Contractor agrees to provide the County with an event
as specified in the Scope of Services below (Event):
a) A one day Street Fair with food, beverage, and arts and craft vendors on Duval Street
b) A evening Masquerade March through the streets of Key west, terminating at the Street
Fair on Duval St
c) A Duval Street Promenade with food and beverage vendors
d) Fantasy Fest parade on Duval Street
e) Coordination and promotion of a minimum of thirty (30) activities sanctioned by Fantasy
Fest
f) Permission to link from the Fantasy Fest website to the TDC/District Homepage
g) Place District I logo on 25,000 (twenty-five thousand) guide books and 25,000 (twenty-
five thousand) schedules
h) Place official District I logo on the Fantasy Fest promotional posters
Event Name: Fantasy Fest
Turnkey Funding: FY 2020
ID #: 2391 _
1
i) Provide permission for District I to use the Fantasy Fest logo for advertising one
Chamber of Commerce district event
3. Expiration of Agreement: This agreement expires on December 30, 2020 unless
the date of the event is amended upon approval of the Advisory Committee and TDC Director
and the County shall not be obligated to pay for any services provided by Event Contractor
under this agreement if documentation as noted above is not received by the TDC
administrative office on or before this reimbursement deadline date.
4. Modification: The event name, time & date of the event and Schedule of
Activities may be amended upon written approval of the Advisory Committee and TDC
Director. Any changes to said contract other than stated above require approval by the,
Advisory Committee, TDC and the County.
5. Non Occurrence of Event: The Event Contractor shall give written notice to the
TDC if it is found necessary to cancel an event. The notice shall contain the reason for the
cancellation.
6. Indemnification and Hold Harmless: The Event Contractor covenants and agrees
to indemnify and hold harmless and defend Monroe County, its officers, employees and agents
including the TDC and Visit Florida Keys from any and all claims for bodily injury (including
death), personal injury and property damage (including property owned by Monroe County)
and any other losses, damages and expenses (including attorney's fees) which arise out of, in
connection with, or by reason of the services provided by Event Contractor, or other activities
and funding associated with this agreement, except those losses or damages caused by the
negligent or wrongful act or omission of County or its agents.
7. Claims and Venue: Event Contractor agrees to notify County immediately of any
claims; suits or action made against the Event Contractor that is related to the activity under
this agreement, and will cooperate with County in the investigation arising as a result of any
action, suit or claim related to this agreement. Any legal proceedings arising out of this
agreement shall be in accordance with the laws of the State of Florida in the 16th Judicial
Circuit for Monroe County; venue shall be in Monroe County, Florida.
8. Non-Waiver of Immunity: Notwithstanding the provisions of Sec. 768.28, Florida
Statutes, the participation of the Event Contractor and the County in this Agreement and the
acquisition of any commercial liability insurance coverage, self-insurance coverage, or local
government liability insurance pool coverage shall not be deemed a waiver of immunity to the
extent of liability coverage, nor shall any contract entered into by the County be required to
contain any provision for waiver.
9. Insurance Requirements: Event Contractor as a pre-requisite of the Special
Event governed by this agreement shall obtain, at its own expense, insurance as specified in
this section. If a Turnkey event is delayed or canceled for any reason, no payment shall be
forthcoming, even if the Event Contractor has out-of-pocket expenses leading up to the actual
event. The TDC, therefore, strongly recommends that the Event Contractor purchase
Event Name: Fantasy Fest
Turnkey Funding: FY 2020
ID#: 2391
2
insurance that covers the cancellation or delay of an event due to "force majeure" or
unforeseen circumstances.
Event Contractor shall furnish the County with a certificate evidencing the
insurance required by this paragraph no later than twenty (20) days prior to the event.
Event Contractor must have their insurance agency email the certificates of insurance
directly to . Maria Slavik in the Monroe County Risk Management Department. Slavik-
Maria@MonroeCounty-FL.Gov — The email must state that this is a certificate for a TDC
event (state name of event as written within your contract) and should be forwarded to
Ammie Machan at the TDC administrative office. Your certificate must state that the
Monroe County Board of County Commissioners is a "Certificate Holder" and that
Monroe County, its employees and officials will be included as "additional insured". If
you or your insurance agency needs to speak with Maria Slavik regarding the insurance
requirements, she can be contacted by telephone at (305) 295-3178, or by email at the
address stated above.
It is the Event Contractor's responsibility to confirm that the insurance has been
received and approved. You can do this by contacting Ammie Machan at Ammie@fla-
keys.com or by calling (305) 296-1552.
Event Contractor will not be permitted to commence work associated with the Event
(including pre-staging of personnel and material) until satisfactory evidence of the required
insurance has been furnished to the County as specified below. Event Contractor shall
maintain the required insurance throughout the entire duration of the Special Event and any
extensions specified in any attached schedules. Failure to comply with this provision may
result in the immediate suspension of the Event until the required insurance has been
reinstated or replaced. Event.Contractor shall provide, to the County, as satisfactory evidence
of the required insurance, either:
Original certificate of Insurance
or
Certified copy of the actual insurance policy
A certified copy of any or all insurance policies required by this contract shall be filed
with the Clerk of the County prior to the Event.
All insurance policies must specify that they are not subject to cancellation, non-
renewal, material change or reduction in coverage unless a minimum of thirty (30) days prior
notification is given to the County by the insurer.
Acceptance and/or approval of Event Contractor's insurance shall not be construed as
relieving Event Contractor from any liability or obligation assumed under this contract or
imposed by law.
Event Name: Fantasy Fest
Turnkey Funding: FY 2020
ID#: 2391
3
Any deviations from these General Insurance Requirements must be requested in
writing on the County form titled "Request for Waiver of Insurance Requirements" and must be
approved by Monroe County Risk Management.
Prior to commencement of work governed by this contract, Event Contractor shall
obtain General Liability Insurance. Coverage shall be maintained throughout the life of the
contract and include, as a minimum:
* Premises Operations
* Products and Completed Operations
* Blanket Contractual Liability
* Personal Injury Liability
* Expanded Definition of Property Damage
The minimum limits acceptable shall be:
* $1,000,000.00 Combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
* $ 500,000.00 per Person
* $1,000,000.00 per Occurrence
* $ 100,000.00 Property Damage
An Occurrence Form policy is preferred. If coverage is provided on a Claims Made
policy, its provisions should include coverage for claims filed on or after the effective date of
this contract. In addition, the period for which claims may be reported should extend for a
minimum of twelve (12) months following the acceptance of work by the County. Recognizing
that the work governed by this contract involves the sales and/or distribution of alcoholic
beverages, the Contractor's General Liability Insurance policy shall include Liquor Liability with
limits equal to those of the basic coverage.
A separate Liquor Liability policy is acceptable if the coverage is not more restrictive
than the contractor's General Liability policy.
A Workers' Compensation insurance is required by Florida Statutes.
10. Permits: The Event Contractor will secure all required permits, licenses and shall
pay all appropriate business taxes.
11. Laws and Regulations: Any and all services, materials and equipment shall
comply fully with all Local, State and Federal laws and regulations.
12. Taxes: The County and TDC are exempt from Federal Excise and State of
Florida Sales Tax, but this in no way exempts the Event Contractor from applicable Federal
and State taxes.
Event Name: Fantasy Fest
Turnkey Funding: FY 2020
ID#: 2391
4
13. Finance Charges: The County and TDC will not be responsible for any finance
charges.
14. Relation of County/TDC: It is the intent of the parties hereto that the Event
Contractor shall be legally considered as an independent contractor and that neither it nor its
employees shall, under any circumstances, be considered servants or agents of the County
and TDC, and the County and TDC shall at no time be legally responsible for any negligence
on the part of said Event Contractor, its employees or agents, resulting in either bodily or
personal injury or property damage to any individual, firm or corporation.
15. Disclosure: The Event Contractor shall be required to list any or all potential
conflicts of interest, as defined by Florida Statutes Chapter 112 and Monroe County Code.
The Event Contractor shall disclose to the County and TDC all actual or proposed conflicts of
interest, financial or otherwise, direct or indirect, involving any client's interest which may
conflict with the interest of the County and TDC.
16. Assignment: The Event Contractor shall not assign, transfer, convey, sublet or
otherwise dispose of this agreement, or of any or all of its right, title or interest therein, or his or
its power to execute such agreement to any person, company or corporation without prior
consent of the TDC and County.
17. Compliance with Laws - Nondiscrimination: County and Event Contractor agree that
there will be no discrimination against any person, and it is expressly understood that upon a
determination by a court of competent jurisdiction that discrimination has occurred, this
Agreement automatically terminates without any further action on the part of any party,
effective the date of the court order. County or Event Contractor agree to comply with all
Federal and Florida statutes, and all local ordinances, as applicable, relating to
nondiscrimination. These include but are not limited to: 1) Title VII of the Civil Rights Act of
1964 (PL 88-352) which prohibits discrimination on the basis of race, color or national origin; 2)
Title IX of the Education Amendment of 1972, as amended (20 USC ss. 1681-1683, and 1685-
1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation
Act of 1973, as amended (20 USC s. 794), which prohibits discrimination on the basis of
handicaps; 4) The Age Discrimination Act of 1975, as amended (42 USC ss. 6101-6107) which
prohibits discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of
1972 (PL 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; 6)
The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation
Act of 1970 (PL 91-616), as amended, relating to nondiscrimination on the basis of alcohol
abuse or alcoholism; 7) The Public Health Service Act of 1912, ss. 523 and 527 (42 USC ss.
690dd-3 and 290ee-3), as amended, relating to confidentiality of alcohol and drug abuse
patient records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC ss. 3601 et seq.), as
amended, relating to nondiscrimination in the sale, rental or financing of housing; 9) The
Americans with Disabilities Act of 1990 (42 USC s. 12101 Note), as maybe amended from time
to time, relating to nondiscrimination on the basis of disability; 10) Monroe County Code
Chapter 14, Article II, which prohibits discrimination on the basis of race, color, sex, religion,
national origin, ancestry, sexual orientation, gender identity or expression, familial status or
age; 11) any other nondiscrimination provisions in any Federal or state statutes which may
apply to the parties to, or the subject matter of, this Agreement.
Event Name: Fantasy Fest
Turnkey Funding: FY 2020
ID#: 2391
5
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18. Security Protection: The Event Contractor agrees to provide adequate security
for the event.
19. Ethics Clause: The Event Contractor warrants that it has not employed, retained
or otherwise had act on its behalf, any former County officer or employee in violation of Section
2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of
Ordinance No. 10-1990. For, breach or violation of the provision the County may, at its
discretion, terminate this agreement without liability and may also, at its discretion, deduct from
the agreement or purchase price, or otherwise recover the full amount of any fee, commission,
percentage, gift or consideration paid to the former or present County officer or employee.
20. Media Rights: The TDC shall have the right under this agreement to broadcast
or rebroadcast, for any purpose whatsoever, radio, television, sound, video or film production,
and still photographs, paid by the TDC and County, and produced by the TDC agencies of
record.
21. Logo: Marketing promotions that display our logo must use the "Key West —
Close to Perfect — Far from Normal" logo/trademark (as per attached logo sample — Exhibit
A). Electronic format (eps or jpg file) of the appropriate logo may be obtained by contacting
Danielle Salman or John Underwood with Tinsley Advertising at 305-856-6060.
22. Severability: If any provision of this agreement shall be held by a court of
competent jurisdiction to be invalid or unenforceable, the remaining provisions shall not be
affected thereby; and each provision of this agreement shall be valid and enforceable to the
fullest extent permitted by law.
23. Authority: Each of the signatories for the Event Contractor below certifies and
warrants that: a) the Event Contractor's name in the agreement is the full name of the
person/entity or corporation as designated in its corporate charter, and b) they are empowered
to act and execute the agreement for the Event Contractor and c) this agreement has been
approved by the Event Contractor's governing board, as applicable to corporations.
24. Public Entities Crimes: A person or affiliate who has been placed on the
convicted vendor list following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit a bid on a contract
with a public entity for the construction or repair of a public building or public work, may not
submit bids on leases of real property to public entity, may not be awarded or perform work as
a contractor, supplier, subcontractor or consultant under a contract with any public entity and
may not transact business with any public entity in excess of the threshold amount provided in
Section 287.017, for category two for a period of 36 months from the date of being placed on
the convicted vendor list.
25. Governing LawNenue: This agreement shall be governed by and construed in
accordance with the laws of the State of Florida applicable to contracts made and to be
performed entirely in the State. In the event that any cause of action or administrative
Event Name: Fantasy Fest
Turnkey Funding: FY 2020
ID#: 2391
6
proceeding is instituted for the enforcement or interpretation of the agreement, the County and
Event Contractor agree that venue shall lie in the appropriate court or before the appropriate
administrative body in Monroe County, Florida. This agreement shall not be subject to
arbitration.
26. Accounting and Records: Event Contractor shall maintain records pursuant to
generally accepted accounting principles for four (4) years after the event and shall permit
County and its agents and employees access to said records at reasonable times.
27. Notice: Any notice required or permitted under this agreement shall be in writing
and hand delivered or mailed, postage prepaid, to the other party by certified mail, returned
receipt requested to the following:
For Grantee: Nadene Grossman Orr
Key West Tourist Development Association, Inc.
922 Caroline St.
Key West, FL 33040
For Grantor: Maxine Pacini
Monroe County Tourist Development Council
1201 White Street, Suite 102
Key West, FL 33040
And
Christine Limbert-Barrows, Asst. County Attorney
P.O. Box 1026
Key West, FL 33041-1026
28. Breach and Penalties: The parties agree to full performance of the covenants
contained in this agreement, and the County reserves the right at its discretion, provided such
breach is material, to terminate this agreement for any misfeasance, malfeasance or
nonperformance of the agreement terms or negligent performance of the agreement terms by
the Event Contractor.
29. Termination of Agreement: County may terminate this agreement without cause
by providing written notice to Event Contractor, through its officer, agent or representative, no
less than sixty (60) days prior to the event and may terminate for breach upon providing to
Event Contractor, through its officer, agent or representative, written notice at least seven (7)
days prior to the effective date of the termination. Notice is deemed received by Event
Contractor when hand delivered, delivered by national courier with proof of delivery, or by U.S.
mail upon verified receipt or upon the date of refusal or non-acceptance of delivery.
30. Miscellaneous: As used herein, the terms "contract" and "agreement" shall be
read interchangeably.
Event Name: Fantasy Fest
Turnkey Funding: FY 2020
ID#: 2391
7
1
31. Entire Agreement: The parties agree that the agreement above constitutes the
entire agreement between the County and Event Contractor. ,1
0.
41P1i .A/T SsN, EREOF, the parties hereto have executed this agreement the day and year
ifefOtt,\I'VOtt
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1c41 Cs. „ (s * ' Yr l:, Board of County Commissioners
,,o� t7 ti15e 4 Madok, Clerk of Monroe County
•
•
•
Deputy Clerk Mayor hai n IV 3
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Key West Tourist
Development Association, Inc. AND'IWO WITNESSES
By li° 4\A--,_-_ "... ._
President / n
�3}¢:vt �GW�i��3 Print Name: M Mic, Uaf t�c a ,
Print Name - Date: Ivl
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Date: ct Ivi 14 (2)
Print Na CArr C\ A,UI;
Date:
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nMONROE COUNTY ATTORNEY
� APGAS 0 RM: ,
CHRISTINE LIMBERT-BARROWS
ASSISTANT ATTORNEY
DATE: /
Event Name: Fantasy Fest
Turnkey_Funding: FY 2020
ID#: 2391
8
1
EXHIBIT A
Color ads four (4) color processing printing
Black & white ads shall include the appropriate generic or district logo in high resolution
TV: logo must appear at the conclusion of commercial
Radio Advertising: No logo is required. All radio announcements must say "Brought to you
by the Monroe County Tourist Development Council."
Marketing promotions that display our logo must use the "Key West — Close to Perfect — Far
from Normal" logo/trademark. Electronic format (eps or jpg file) of the appropriate logo may be
obtained by contacting Danielle Salman or John Underwood with Tinsley Advertising at 305-
856-6060.
The Florida Keys
KeyVest
Close To Perfect - Far From Normal
Event Name: Fantasy Fest
Turnkey Funding: FY 2020
ID#: 2391
9
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101 i Edition
INSURANCE CHECKLIST FOR VENDORS SUBMITTING PROPOSALS OR BIDS
FOR WORK
To assist in the development of your proposal, the insurance coverages marked with an "X" will
be required in the event an award is made to your firm. Please review this form with your insurance
agent and have him/her sign it in the_ place provided. It is also required that the bidder sign the
requiste form reflecting coverage and submit it with the proposal.
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
Workers' Compensation Statutory Limits
•
Bodily Injury by Accident/Bodily
• Injury by Disease, policy
limits/Bodily Injury by Disease
each employee
WCI Employers Liability $1 00,000/$500,000/$1 00,000
•
WC2 Employers Liability $500,000/$500,000/$500,000
WC3 Employers Liability $1,000,000/$1,000,000:$1,000,000
WCUSLH US Longshoremen & $1,000,000
Harbor Workers Act
WCJA Federal Jon Act $1,000,000
•
•
Adminislralivc:Inslruclion 7500.7
6
2018 Edition
GENERAL LIABILITY
As a minimum,the required general liability coverages will include:
Premises Operations 0 Products and Completed Operations
Blanket Contractual e Personal Injury
Required Limits:
GLI $300,000 Combined Single Limit
GL2 $500,000 Combined Single Limit
GL3 X $1;000,000 Combined Single Limit
GL4 S2,000,000 Combined Single Limit
GLS $3,000.000 Combined Single Limit
GL6 $4,000,000 Combined Single Limit
GL7 $5,000,000 Combined Single Limit
Required, Endorsement:
GLLIQ Liquor Liability
GLS Security Services
All endorsements arc required to have the same limits as the basic policy.
•
INSCKLST
Administrative Instruction 7300.7
7
. 2015 Edition
BUSINESS••AUTOMOBILE LIABILITY
As a minimum, coverage should extend to liability for:
• Owned; Non-owned; and Hired Vehicles
Required Limits:
VLI $50,000 per Person:$100,000 per Occurrence
$25,000 Property Damage
Or
$100,000 Combined Single Limit
(The use of VLI should be limited to special projects that involve
other governmental entities or"Not for Profit"organizations. Risk
Management must approve the use of this form).
VL2 $200,000 per Person; $300,000 per Occurrence
$200,000 Property Damage
or
$300,000 Combined Single Limit
VL3 • $500,000 per Person;S1,000,000 per Occurrence
$100,000 Property Damage
or
$1,000,000 Combined Single Limit
VL4 $5,000,000 Combined Single Limit
MISCELLANEOUS COVERAGES
BRI Builders' Limits equal to the
Risk Full Replacement Value of the completed
project.
CLI Cyber Liability $1,000,000
MVC Motor Truck Limits equal to the maximum
Cargo value of any one shipment.
PRO I Professional $ 300,000 per Occurrence-$ 500,000 Agg.
PRO2 Liability $ 500,000 per Occurrencei$1,000,000 Agg.
PRO3 ' • $1,000,000 per Occurrencei$2,000,000 Agg.
POLL Pollution $ 500,000 per Occurrencel$(,000,000 Agg.
POL2 Liability $1,000,000 per Occurrencel$2,000,000 Agg.
POL3 $3,000,000 per Occurrencel$6,000,000 Agg.
POLO $5,000,000 per Occurrence/$10,000,000 Agg.
EDt Employee $ 10,000
ED2 Dishonesty $100,000
GKI Garage $ 300,000 ($ 25,000 per Vehicle)
GK2 Keepers $ 500,000 ($100,000 per Vehicle)
GK3 $1,000,000 ($250,000 per Vehicle)
Administrative Instruction 7500.7
4
2018 Editb n
MEDI Medical $ 300,000Y$ 750,000 Agg.
MED2 Professional $ 5.00,000/$ 1,000,000 Agg.
MED3 $1,000,0005 .3,000,000 Agg.
MED4 $5,000,000$10,000,000 Agg.
IF Installation Maximum value of Equipment
Floater Installed
VLPI Hazardous $ 300,000 (Requires MCS-90)
VLP2 Cargo $ 500,000 (Requires MCS-90)
• VLP3 Transporter $1,000,000 (Requires MCS-90)
BL:L Bailee Liab. Maximum Value of County Property that
will be in the Bailee's posession.
HK.LI Hangar keepers $ 300,000
HK.L2 Liability $ 500,000
HK.L3 $ 1,000,000
HK.L4 $ 5,000,000
A1RI Aircraft $ 1,000,000
AIR2 Liability $ 5,000,000
AIRS $50,000,000
AE01 Architects Errors $ 250,000 per Occurrence,$ 500,000 Agg.
AE02 & Omissions $ 500,000 per Occurrencel$1,000,000 Agg.
A E03 $ 1,00.0,000 per OccuiTencel$3,000,000 Agg.
AE04 $ 3,000,000 per Occurrencel$5,000,000 Agg.
ARP All Risk Property Full Replacement Value oiStmcture
EOJ Engineers Errors $ 250,000 per Occurrence;$ 500.000 Agg.
E02 & Omissions $ 500,000 per Occurrence31,000,000 Agg.
E03 $ 1,000,000 per Occurrencee$2,000,000 Agg.
E04 $ 5,000,000 per Occun•ence.1$10,000,000 Agg.
• WLI Water Craft $ 500,000 per Occurrence
WL2 Liability $ 1,000,000 per Occurrence
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Administrative Instruction 7300.7
9
2018 Edition
INSURANCE AGENT'S STATEMENT
I have reviewed the above requirements with the bidder named below.The following deductibles
apply to the corresponding policy.
Policy Deductibles •
Liability policies are _[] Occurrence ❑Claims Made
di-Kurafic_leAr--it)eri -
Insurance Agency Signatur '�
BIDDERS
•
STATEMENT
I understand the insurance that will be mand ory if a rded the c t act and
will comply in full with all the requirements.
NO4A-eile a. 01W c 1 � �rec-4W
Bidder's Name and Title Signature
Company Name: �h.f F rcS -P—S`-
•
•
Adminilralivc lnlniclion 7500.7
Ill